Isotretinoin has revolutionized the treatment of acne by improving the cosmetic outcome and decreasing the psychological damage. However, use of isotretinoin is associated with significant side-effects such as mucocutaneous involvement, dyslipidaemia and liver dysfunction, as indicated by increases in liver enzymes. The responsible enzyme for homocysteine metabolism, cystathionine-beta-synthase, might also be affected by isotretinoin-induced liver dysfunction, which leads to hyperhomocysteinaemia, an independent risk factor for thrombovascular diseases. The aim of this study was to evaluate homocysteine levels and the responsible vitamins for its metabolism in patients with moderate to severe acne vulgaris on isotretinoin treatment, before and after treatment. We found increased level of homocysteine in patients after 2 months of taking isotretinoin. Our findings suggest that isotretinoin may increase the risk of cardiovascular disorders by causing hyperhomocysteinaemia.

Background and Objectives: Considering the adverse effects of obesity and job stress on the physical and mental health of medical staff and reducing the quality of care, the present study was conducted to assess the level of job stress in overweight and obese nurses and its relationship with demographic factors. Methods: The study population of the present descriptive-correlational research included all nurses and paramedics working in Ghaem Hospital. The study sample was selected by census and convenience sampling method. The body mass index of nurses and nursing assistances was calculated, and people with overweight and obesity were selected. The standard OSIPOW job stress questionnaire was distributed among samples, consisting of two parts: demographic characteristics and occupational parameters such as workload, incompetence, duality, position range, responsibility, and physical environment. Based on the scores in each area, the level of job stress was determined and divided into four levels: low, normal, moderate, and severe. Statistical analysis of the collected data was performed using SPSS v. 21. Results: More than 57% of the samples had moderate to severe stress. Body mass index is significantly higher than the standard number (179.07 vs 149 kg/m2), which indicates the presence of overweight and obesity in these people. In general, there was no significant relationship between overweight/obesity with job stress (P>0.05). There was also no significant difference between the mean job stress and variables of gender, age, education, and work experience (P>0.05). The only difference was related to different job positions, so that the nursing assistance group had the lowest level of stress and the head nurse group had the highest level of job stress. Conclusion: Because of the high level of job stress and overweight of nurses, it is suggested to take steps to reduce issues related to overweight and job stress with appropriate management measures and periodic planning.

Background and Aim: Cardiovascular disease, especially myocardial infarction, is one of the common causes of death, disability, and productivity reduction globally, which is also rising in Iran. This study evaluated the share of modifiable and non-modifiable risk factors in myocardial infarction in the Iranian population. Materials and Methods:A descriptive-analytic and retrospective study was conducted on 361 patients with myocardial infarction in Alborz, Iran, in 2015-2019. Data collection was done by reviewing records of patients diagnosed with myocardial infarction with ECG changes or increased cardiac enzymes (CPK-MB, Troponin I). Then required information was extracted, and intended data were analyzed with descriptive and inferential statistics by the SPSS software.Results: Among the subjects in the study, 71/1% were male, and 28/9% were female. The majority of samples were between the ages of 60 to 71(33/8%), and the least of them were under 30 years old (1/7%). 82.68% of the samples had a positive family history. The most common modifiable risk factors of myocardial infarction in this study were first Hypertension (42/4%), then Diabetes (31/6%), smoking (32/04%), and Hyperlipidemia (15%). Hypertension was significantly associated with gender, age, and diabetes, and Hyperlipidemia is also positively associated with diabetes and Hypertension. Conclusion:Myocardial infarction is common in men and patients with Hypertension in the Iranian population. High blood pressure is also associated with gender, age, and diabetes. The prevalence of both modifiable and non-modifiable risk factors and coronary artery occlusion increases with increasing age. Therefore, training a healthy lifestyle and controlling modifiable risk factors from an early age can significantly prevent various cardiovascular diseases in the future.

Introduction:One of the most common forms of chronic liver disease related to lifestyle is nonalcoholic liver disease. Objectives: The present study was conducted to compare weight and waist circumference of patients with and without non-alcoholic fatty liver disease (NAFLD) referred to hospitals affiliated to Tehran University of Medical Sciences in 2017. Patients and Methods:This case-control study was carried out on 300 outpatients and inpatients patients aged between 18 to 65 years referred to the ultrasonography section of hospitals with convenience sampling method. Based on the results of ultrasonography, these subjects were divided into two groups; case (100 patients) and control group (200 subjects). Results: The mean BMI (body mass index) and waist circumferences of patients without NAFLD were 22.47 ± 1.97 kg/m 2 and 83.84 ± 8.68 cm, respectively, while in the patients with fatty liver the mean BMI and waist circumference were 26.10 ± 2.21 kg/m 2 and 98.83 ± 7.28 cm, respectively (P = 0.001). Conclusion:The results of the data analysis showed that the patients with fatty liver have high levels of BMI in comparison with those who had not fatty liver. Regarding the high prevalence of nonalcoholic fatty liver, lifestyle changes and the implementation of educational interventions to increase awareness are necessary. AbstractCitation: Akbari M, Zohari-Anboohi S, Borzabadi-Farahani Z, Nasiri M, Esteki T. Comparison of body mass index and waist circumference of patients with and without nonalcoholic fatty liver in Tehran.

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